Keto Adapted Blood Sugar Levels

The Keto Adaptation Process

So, what is the keto adaptation process? Minimal consumption of carbohydrate (< 50 grams/day) for an extended period of time results in a phenomenon called keto adaptation. Keto adaptation denotes an altered metabolism in which fat becomes the predominant energy source, consequently, shifting the body from a state of fat storage to fat oxidation (1). The biochemical modifications essential to transition from a “glucocentric” (reliance on glucose for fuel) to an “adipocentric” (reliance on fatty acids and ketone bodies for fuel) metabolism require carbohydrate restriction for several weeks to months (2). Two common approaches to become keto-adapted include sustained consumption of a very low-carbohydrate/high-fat ketogenic diet (KD) or an extended period of fasting. Low Insulin / High Glucagon Surges of glucose enter the bloodstream after consumption and digestion of dietary carbohydrates. To prevent glucose from reaching high/toxic levels in the circulation, the pancreas releases insulin, a hormone that signals tissues to store excess glucose in the form of glycogen or leads to storage of fat in adipose tissue (body fat). On the other hand, restriction of carbohydrate intake results in limited exogenous glucose availability (i.e., dietary glucose) and as a result, blood glucose levels must be maintained endogenously (inside your own body). For example, unlike a mixed diet (moderate to high carbohydrate), a study demonstrated that individuals who adapted to a KD for 12 weeks showed no increase in blood glucose or insulin following a meal (3). Therefore, consuming a carbohydrate-restricted diet such as the KD would not raise blood glucose levels directly. During dietary carbohydrate restriction, the pancreas releases another hormone known as glucagon in response t Continue reading >>

High Blood Sugar In Ketogenic Dieters! Plus A Special Surprise (hint: Genotypes And Metabolism)!

A while ago Michael and I were discussing future article topics. There are truly a plethora of avenues to go down in this area of research and there is no lack of things to research and comment on. But even though I have a couple of pretty cool MCT articles sitting around on my desk, I want an interesting topic. I want something new. Something challenging. Besides, everyone is drinking the MCT koolaid these days. It’s become passe. (Also, it upsets my stomach and I have a personal vendetta against it. So there.) What’s new? There has to be something new! Michael pointed me to one of his old articles on physiological insulin resistance as an idea. I brushed it off at first. Dismissed it as a quirk. But then I thought about it. WHY does blood glucose rise in response to a low carb diet? It truly is an interesting question. What does it say about low carb diets if they induce an almost diabetic effect on circulating glucose? Thus my research began. This short abstract confirmed that it is normal for people on low carb diets to experience a rise in blood glucose levels. Because it’s a non-open journal (shame!), there’s a one-sentence explanation given: A decrease in first-phase insulin secretion may partially contribute to the short-term LC/HFD-induced increase in postprandial plasma glucose levels. First phase insulin secretion? There’s a first phase? So… There’s more than one phase to insulin secretion? I had no idea. Call me ignorant but I had no idea until this point that there was more than one phase to insulin secretion. This article delves deeper into the signaling involved in (what I learned is called) biphasic insulin secretion. The first phase of insulin secretion lasts approximately 10 minutes, and the second phase of insulin secretion picks up afte Continue reading >>

The Ketogenic Diet And Insulin Resistance

We recently touched on how you can use the ketogenic diet to control symptoms of diabetes such as elevated glucose and triglycerides. In this article, we examine research showing the impact that the ketogenic diet has on levels of the hormone insulin, a key regulator of blood sugar in the body. What is Insulin’s Role in the Body? Before we look at the research, we need to know our main players. Insulin is a protein-based hormone produced by beta-cells located in the pancreas. The pancreas, which is located under the stomach, also produces enzymes that aid with digestion. Insulin’s primary purpose is to regulate the metabolism of fats and carbohydrates. The digestive system breaks down carbohydrates, such as sugars and starches, into a molecule called glucose. This compound can be used by cells to produce energy through a process called cellular respiration. Insulin allows cells in the body absorb glucose, ultimately lowering levels of glucose in the blood stream. After a meal is consumed, blood glucose levels increase and the pancreas responds by releasing insulin into the blood. Insulin assists fat, liver, and muscle cells absorb glucose from the blood, resulting in lower levels of blood glucose. Insulin stimulates liver and muscle tissues to store excess glucose as a molecule called glycogen and also reduces glucose production by the liver. When blood sugar is low, the hormone glucagon (produced by alpha-cells in the pancreas) stimulate cells to break down glycogen into glucose that is subsequently released into the blood stream. In healthy people who do not have type II diabetes, these functions allow levels of blood glucose and insulin to stay in a normal range. What Is Insulin Resistance and Why Is It a Problem? Unfortunately, for many Americans and other peopl Continue reading >>

Ketogenic Diet Faqs Frequently Asked Questions

Ketogenic diet FAQs frequently asked questions Ketogenic diet FAQs frequently asked questions Here is a compiled list of answers to the FAQs people have. Many people have questions about the ketogenic diet before they get started. So, weve compiled a list of answers to the frequently asked questions that people have. What is keto-adaptation and what does it feel like? The term keto-adaptation refers to your body's transition from burning primarily glucose as fuel, to being able to also use ketones produced from burning body fat. It will take a few days or weeks to feel your absolute best on keto. You may experience symptoms of carbohydrate withdrawal at first, but once you become fat-adapted, you'll find that you won't crave carbs as much anymore. What is the "keto flu" and how can I avoid it? Your body has always relied on glucose as its primary source of energy. Therefore, when you cut carbohydrates drastically, the body is essentially freaking out, until it eventually switches its metabolism to burning fat. This period of adaptation causes the mild physical weakness or lack of energy typical of the flu. This state is temporary and the transition can be facilitated by a few preventive measures, such as keeping hydrated and having enough salt. Visit our keto side effects page to know more about effective ways to help circumvent the keto flu. How long does it take to become keto-adapted? Most research papers and anecdotal evidence you'll come across state that keto-adaptation can last up to four weeks. The more determined you are to avoid carbs in the first weeks of a ketogenic diet, the quicker you'll be over the hump on your keto-adaptation. You can also hasten it by engaging in any form of sustained physical activity which will force your body to tap into its fat st Continue reading >>

The High Blood Glucose Dilemma On Low Carb (lc) Diets

If you are on a ketogenic or very low carb (VLC) diet (e.g. with 50-100gr carb/day and/or eating ketone producing MCT oils such as coconut oil), you may have a dilemma of having high Blood Glucose (BG) despite eating LC: If you are keto adapted, that is, your body is using ketones and even though you have sufficient insulin (say >5 microU/ml) your body tries to keep your BG higher than necessary, e.g. above 100-110 mg/dl. That is your BG set-point is always high. If you try to lower the set-point to say 80s, by water Intermittent Fasting (IF), then your body starts to convert your muscles into glucose to keep its high BG set-point. So, you may have a slightly lower BG, but you lose some muscle mass. Having a high set-point has many other problems, e.g. if you eat something with a little bit more carb, say a small fruit, your BG shoots up to 130s and stays there for hours. This may be due to something called "Physiological Insulin Resistance (PhIR) by Petro Dobromylskyj. He wrote many good articles about it -???thanks Petro--in his blog Hyperlipid. Apparently, PhIR is a normal reaction of the body and quite different from Pathological Insulin Resistance (PaIR). It seems that the main difference between PhIR and PaIR is that insulin is at a normal level in the former and abnormally high in the latter. (PaIR is obviously type2 diabetes.) If I understand correctly, PhIR is kind of IR only in the muscle tissue, that is only the muscles do not react to insulin and NOT use glucose even though it is available. However, if you are eating too much protein, the liver may also be considered IR, because it tries to keep the BG high by converting proteins to glucose, even though BG is already too high, that is, it also may not be responding to insulin. (I think working muscles can us Continue reading >>

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>

Why The Brain Is Key To Your Keto-adaption

Your brain only represents 2% of your bodyweight, yet uses 20-25% of your total resting energy expenditure. Roughly 500 calories per day are needed just for the brain. If you have always eaten a high carb based diet your brain runs on 100% glucose (carbohydrates). And you only have a very small reservoir of glucose available to you. I will try and show you why your brain is really the key piece of the puzzle in keto-adaption. First I need to explain a few things. Our body`s cells can use 2 sources of fuel for energy, glucose (carbohydrate), or fat. There are a few cells that can only use glucose for energy. It is because of these cells, that the human body must maintain a certain level of glucose, at all times. This is called glucose homeostasis. Glucose homeostasis simply means this. The human body is required to maintain tight control of your blood sugar levels 70-110. It is required to maintain this level of blood sugar for the few cells, that can only use glucose for energy. These cells are found in the brain (if not keto-adapted), the red blood cells, a few in the kidneys, and your retinas. Also if your blood sugar goes much over 110, this becomes toxic to your cells, and if your blood sugar goes to low, you will not have the necessary glucose needed, to maintain fuel, to these cells. So this is glucose homeostasis. Why is this important? The brain, being the main control center of the body, must be keep going every second, of every day. The red blood cells carry the oxygen in the bloodstream, You must be able to breath, to remain alive. Your kidneys filter your blood, No more blood, and you are no longer alive, And I would say your eyesight is pretty important also. Here are the amounts of glucose needed daily, for the cells that can only run on glucose. 1- The br Continue reading >>

Ketones And Ketosis

According to Owsley “The Bear” Stanley This is not a dedicated nor complete article, this page is an extract from Owsley’s correspondence with others. See this page for more info. A zero carb diet does NOT cause ketosis. The body rapidly adapts within a few weeks and begins consuming the ketones from fat metabolism. A fully keto-adapted body excretes no ketones in the urine. A metabolic by product, ‘ketone bodies’ are actually a special kind of carb, and they substitute for glucose at the structures which use it. They have the added advantage of making you feel good- and well fed. Ketone metabolism is not a ‘rapid response mechanism’. Full keto-adaptation takes several weeks, and until that has been done, a slowly reducing level of ketones will spill into the urine. Once adapted, the ketones are barely present in the urine, having been used by the body (in place of glucose). You will not show ketones in your urine if there are carbs in your diet, the ketones are reprocessed- into bodyfat. Your body ONLY burns FAT for muscular work, and it burns fat all the time, 24/7. Ketones do not appear in the urine until all carbs are stopped and then the ketones will disappear again in a few weeks as your body begins using them as glucose-replacement rather than converting them, as it does all carbohydrates, into bodyfat (from which they came). BOTH a keto-adapted and carb-eating person will show no ketones in the urine. SOME people have a problem with fat metabolism while insulin is present, and glucose being converted into bodyfat, but not everyone, which is why some (a few) people do not become fat or obese no matter what they eat. Those who have a problem find any effort very hard and may fall asleep until the fat storing process is over. Ketones are a valuable nu Continue reading >>

Being Fat Adapted Versus "in Ketosis" (pt.1/3)

UPDATE!! (9/20/2017) I have a new post that explains how and why the body produces ketones, It will help you understand much better the difference between burning fat and having a fat-based metabolism, versus being "in ketosis." It's very long, but I think it's worth reading if you'd really like to understand this -- and if you want to stop freaking out about your ketone levels. (If you click over to that post and want to read only the section that explains the difference between ketosis and running on fat, scroll way down to where it says Ketogenesis: How and Why Do We Make Ketones? Also: Fat Adaptation versus Ketosis.) Happy reading! If I never hear or read those six words, in that order, ever again, I’ll be one happy individual. Based on what I come across on low-carb forums, blogs, and videos, there is a lot of confusion about the correct use of urine ketone test strips (which I’ll sometimes refer to as ketostix, since “ketone test strips” is a mouthful, even when you’re only reading). So allow me to ‘splain a little bit about how to interpret these things, and what role they should play—if any—in your low-carb life. First and foremost is the most important thing you will read in today’s post. (And it is so important that I will likely repeat it in all the posts to follow in this little series. Plus, you can tell it’s important because it’s red, bold, in italics, and all caps, hehheh.) You can be in ketosis and not lose body fat, and you can lose body fat without being in ketosis. Here is an exhaustive, comprehensive list of everything urine ketone test strips tell you: There is acetoacetate in your urine. That’s it. Nothing more. Nada más. Game over. Finito. The fat lady has sung, and Elvis has left the building. Your worth as a human being Continue reading >>

Optimal Ketone And Blood Sugar Levels For Ketosis

A low carb helps reduce blood sugars and insulin levels and helps with the management of many of the diseases of modern civilisation (e.g. diabetes, heart disease, stroke, cancer, Parkinson’s and Alzheimer’s). We become insulin resistant when our body fat can’t store any more energy. Excess energy is then stored in the liver, pancreas, heart, brain and other organs that are more insulin sensitive. We also see increased levels of energy in our blood in the form of glucose, fat and elevated ketone. Endogenous ketosis occurs when we eat less food than we need. Our insulin and blood sugar levels decrease and ketones rise to supply the energy we need. Exogenous ketosis occurs when we eat lots fat and/or take exogenous ketones. Blood ketones rise, but our insulin levels will also rise because we have an excess of energy coming from our diet. Most of the good things associated with ketosis occur due to endogenous ketosis. Most people following a ketogenic diet over the long term have ketone values lower than what some people consider to be “optimal ketosis”. If your goal is blood sugar control, longevity or weight loss then endogenous ketosis with lower blood sugars and lower ketones is likely a better place to be than chasing higher blood ketones. I have seen a lot of interest and confusion recently from people following a ketogenic about ideal ketone and blood sugar levels. In an effort to try to clear this up, this article reviews blood ketone (BHB), breath ketone (acetone) and blood sugar data from a large number of people who are following a low carb or ketogenic diet to understand what “normal” and “optimal” look like. Many people initiate a low carb diet to manage their blood glucose levels, insulin resistance or diabetes. As shown in the chart below, Continue reading >>

Why Am I Getting Low Ketone Readings On A Ketogenic Diet?

75 Comments Even having finished and printed The Keto Reset, the quest for deeper understanding continues. I keep researching, thinking, revisiting, and discussing the science and practice of ketosis. My writing partner, Brad Kearns, and I maintain a running dialogue on all things keto. The latest conversation revolved around two very common questions or “problems” that keep coming up in the ketogenic community. Why do some people on a keto diet blow high numbers of ketones while others eating the same way blow low numbers? and this one… Is ketosis glycogen-sparing or glycogen-inhibiting? I won’t offer definitive answers fit to etch into stone. I will offer my exploration of the research, some educated speculation, and actionable advice you can ruminate on. And by all means get back to me with your take on the questions and my explorations, please. Dialogue is essential to understanding. Why do some people on ketogenic diets produce low ketone readings when they test? One theory is that some keto-adapted people are so adapted to producing and burning ketones that they don’t leave any extra to spill into the urine and breath. They make only as many as they can use and their cells gobble up almost every ketone they produce. Under this argument, low ketone numbers on a ketogenic diet are a reliable sign of full ketone adaptation. This sounds plausible, but I haven’t seen any empirical evidence that it’s the case. Another theory is that the keto-adapted have built so much fat-burning metabolic machinery in their muscles that they can burn free fatty acids directly and don’t require much additional fuel from ketones. They make enough ketones to fuel the brain, since our brain can’t run on fatty acids directly, but your muscles no longer require as many. Man Continue reading >>

4: Fasting For Keto-adaptation, High Blood Ketones, Elevated And Low Blood Sugar, No Weight Loss, Slowing Fat Metabolism

Veteran health podcaster, blogger, international speaker, and bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” teams up with Toronto, Ontario Canada-based nephrologist Dr. Jason Fung from IntensiveDietaryManagement.com and Dr. Fung’s Clinical Director at his Intensive Dietary Management Program clinic Megan Ramos on this podcast dedicated to answering YOUR questions about intermittent, alternate day, and extended fasting. Jimmy and Dr. Fung are the coauthors of the 2016 international bestseller The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting and, along with Megan, are happy to provide this podcast as an additional resource for anyone curious about going on a fast to improve their health. We love hearing from our listeners with new questions–send an email to Jimmy at [email protected]. And if you’re not already subscribed to the podcast on iTunes, then you can do that and leave a review HERE. Listen in today as Jimmy and Megan answer your questions about all things fasting in Episode 4. FREE N=1 TRACKING TOOL AT HEADS UP HEALTH – Whether you should fast when you are sick HOT TOPIC: Can you use fasting as a way to get keto-adapted faster? Can you get keto-adapted faster with fasting? And why do you get angry on the second day of fasting? What do you do about that? Mary KEY QUOTE: “We tell patients not to stop their fast on the third day because that’s usually the hardest, but once you are keto-adapted, you can fast for as many days as you want, usually without implication, so on the third day of my fast I don’t experience any third day hump.”- Megan Ramos 1. Can blood ketones go too high while you are fasting? Hey guys, I’m 71 years old with a low BMI and no medical or h Continue reading >>

Is Your Fasting Blood Glucose Higher On Low Carb Or Keto? Five Things To Know

This past spring, after 18 months of great success on the keto diet, I tested my fasting blood sugar on my home glucose monitor for the first time in many months. The result shocked me. I had purchased the device, which also tests ketones, when I was diagnosed with pre-diabetes in the fall of 2015. As I embarked on low-carb keto eating, I tested my blood regularly. Soon my fasting blood sugar was once again in the healthy range. I was in optimal ketosis day after day. Not only that, I lost 10 lbs (5 kg) and felt fantastic — full of energy with no hunger or cravings. Before long I could predict the meter’s results based on what I was eating or doing. I put the meter away and got on with my happy, healthy keto life. When my doctor ordered some lab tests this spring, I brought the meter out again. While I had no health complaints, excellent blood pressure and stable weight, she wanted to see how my cholesterol, lipids, HbA1c, and fasting glucose were doing on my keto diet — and I was curious, too. To check the accuracy of my meter against the lab results, on the morning of the test I sat in my car outside the clinic at 7:30 am, and pricked my finger. I was expecting to see a lovely fasting blood glucose (FBG) of 4.7 or 4.8 mmol/l (85 mg/dl). It was 5.8! (103 mg/dl). What? I bailed on the tests and drove home — I didn’t want my doctor warning me I was pre-diabetic again when I had no explanation for that higher result. The next morning I tested again: 5.9! (104). Huh??? For the next two weeks I tested every morning. No matter what I did, my FBG would be in 5.7 to 6.0 (102 to 106 mg/dl), the pre-diabetic range again. One morning after a restless sleep it was even 6.2 mmol/l (113 mg/dl). But my ketones were still reading an optimal 1.5-2.5 mmol/l. I was still burnin Continue reading >>

How To Know If You’re In Ketosis: A Guide To Testing Ketone Levels

Ketosis can be a powerful way to use your metabolism for fat loss, mental output, physical performance as well as many other health benefits. But how do you know if you’re actually in ketosis? As the old adage goes “test, don’t guess” when it comes to your health. In this guide, we’ll show exactly how to test your ketone levels to know if you’re in ketosis so you can make sure you’re getting all of the benefits that ketosis has to offer. There are three primary forms of ketones in your body, acetone, acetoacetate, and beta-hydroxybutryate. Each of these compounds do different things in the metabolism of ketosis and can be tested individually with differing techniques. Not all measurement is created equally, however, and some can be better than others for different purposes or times. The three different ketone bodies can be measured when they spill over into three different areas of your body: your breath, urine or blood. The good news is that all of these ketone level measurements can be done at home, by yourself. You don’t have to go to any lab or use any fancy high tech equipment. Tracking diligently, at least when you’re getting used to ketosis based diets, is important so you know how much you react to different variables like exercise, type and amount of food, and amounts of exogenous ketone supplements. Also, the optimal level of ketones for specific goals can vary per person. Knowing the amount where you thrive in the goal you want to achieve (and consistently checking if you’re hitting that amount) is the fastest way to reach your goals. Testing levels of ketones with urine strips (acetoacetate) One of the ketone bodies, acetoacetate, can be measured directly in the urine if they are in excessive levels. The way metabolic substrates get into Continue reading >>

#208: Keto Adaptation And The Gut Liver Axis

You are here: Home / Epigenetics / #208: Keto Adaptation and the Gut Liver Axis #208: Keto Adaptation and the Gut Liver Axis Want Early Access to Interviews and Additional Bonus Content? Become a High Intensity Health Insider and Access Bonus Content In this video, we discuss some of the science about: The relationship between low blood glucose and ketosis Sponsored Content: Learn How to Successfully Incorporate the Ketogenic Diet and Low-Carb Living Into Your Lifestyle for Fat Loss and Better Blood Sugar Balance 00:25 A ketone body is fat repackaged by your liver for energy. The two main metabolites created are beta hydroxybutyrate (BHB) and acetoacetate. When you are eating low carb, insulin levels are low. Your brain and muscle need fuel. When there is no sugar, messages are sent to the liver to make ketone metabolites. 01:47 When you are exercising or fasting, your adipose tissue releases triglycerides and free fatty acids to be repackaged as ketones. Muscle tissue likes to use acetoacetate. BHB fuels muscle contraction. Your brain requires BHB when blood sugar is low. 02:30 BHB has secondary signaling properties. BHB downregulates the NLRP3 inflammasone network, which turns on a number of pro-inflammatory pathways. BHB upregulates Nrf2 (nuclear regulator factor 2), a huge anti-inflammatory phase 2 detox and anti-oxidant signaling hub. Nrf2 turns down NFkB. Glucose does not have secondary beneficial properties. 04:25 Ketones affect histone deacetylase inhibitors (HDACs). Our DNA is sensitive and easily damaged. It is tightly wound around these histone-like proteins. Histone deacetylase inhibitors affect DNA structure and gene signaling. 05:23 Low Ketones: Get back to the basics. It is about more than eating low carb/high fat. There are other considerations: fat tis Continue reading >>